Ashtanga Yoga for Depression & Anxiety?

Could ashtanga yoga be a particularly helpful complimentary approach to managing depression and anxiety, enhancing the benefits of psychotherapy and/or psychopharmacology? We already know from the research that hatha yoga in general can be quite beneficial. But, might there be some aspects of ashtanga yoga in particular that would make it especially well suited? I would love to see some research addressing this hypothesis directly, but in the meantime, here are some of my thoughts on the subject.

Ashtanga yoga is a vigorous practice.

When practiced at a brisk pace, ashtanga yoga can be more aerobic and vigorous than other forms of yoga. The primary series has around 60 chaturangas (low push-ups) as well as numerous jump-backs and jump-throughs, that occur every five breaths or so. This intensity of physical activity is one of the aspects that may make it particularly well suited for helping with depression and anxiety. We already know that moderate exercise is correlated with increased endorphins, norepinephrine, dopamine, serotonin, and other hormones that help us feel content and modulate the body’s stress response. Less vigorous activity may not be as effective. Regular moderate exercisers are less likely to suffer from mental health disorders and those that do, have a decreased rate of relapse. The beneficial effects of moderate exercise tend to be longer lasting than many medications, although the time to take full effect may be longer. Exercise may also impact self-esteem and quality of sleep, which can improve mental health.

Just as a thought provoking aside, the ashtanga yoga primary and intermediate series include many forward folds and inversions, which B.K.S. Iyengar in Light on Yoga and Amy Weintraub in Yoga for Depression describe as beneficial for both depression and anxiety for a variety of physiological reasons. These claims are not yet rigorously scientifically tested, so this is another area where good research could be very helpful.

Ashtanga yoga is a demanding practice.

The practice of ashtanga yoga demands much of its devotees. Practitioners quickly discover how our behavior in everyday life impacts the practice. Many ashtangis report naturally gravitating toward more healthful behavior in service to their practice. We may go to bed earlier so we can awaken refreshed for the early morning practice that is typical of this form of yoga. We may refrain from drinking too much alcohol so we don’t feel fatigued, dehydrated or nauseous. We may also drink more water for the same reason. We may become more conscious of what and when we eat so we don’t feel weighed down or have digestive issues during practice. Many of us forgo meat for this reason, as well as in observance of ahimsa or non-harming (see #4). This leads to eating a more plant-based diet, which we already know is a healthy habit. The intuitive gravitation toward more healthful behavior creates a healthier body, in turn establishing a better foundation for a healthy and balanced mind. Fortunately, the benefits that come from a devoted practice prove to be self-reinforcing and make the sacrifices seem worthwhile.

Ashtanga yoga requires single pointed concentration and mindfulness.

When practicing ashtanga yoga, there is something called the tristhana, or three places of attention (breath, gaze and posture). We are instructed to breathe in a slow, steady and rhythmic manner in coordination with our movements and to take a particular drishti or gaze with each posture. We also activate the bandhas, or energy locks, contracting certain muscles throughout the practice. Along with executing a memorized and challenging sequence of postures, attending simultaneously to all of these aspects of inner experience at once requires considerable concentration. Mind wandering becomes less likely and interestingly, certain types of mind wandering may be an important component of anxiety and depression. Rumination, or repeatedly mulling over past events or future worries, is a major cause of suffering in these disorders. We unconsciously turn to it as a coping mechanism (along with avoidance), creating a painful feedback loop. Attending to experience is an antidote to avoidance and rumination. Ashtangis with a devoted practice spend a couple of hours each day practicing this type of concentration and mindfulness. We learn to maintain equanimity, moving smoothly through the practice, working with whatever arises, returning again and again to the intended points of focus.

Ashtanga yoga remains a spiritual practice in the US.

Research has shown a correlation between spirituality and decreased incidence of depression and anxiety disorders. Yoga was meant to be a spiritual practice, including aspects of ethical behavior, virtuous observances, meditation, and a journey toward enlightenment. However, here in the West there is an increasing focus on the physical aspects of yoga with a corresponding decrease in focus on the more spiritual aspects of the eight-limbed path. It seems to me that the practice of ashtanga yoga has managed to maintain much of this connection, perhaps because it has remained close to its lineage and is still seen as a system of purification and healing – not just a series of postures. Many teachers continue to recite the opening and/or closing mantra in their classes, teach the other limbs of yoga during workshops, and recommend pranayama (breathwork) and meditation as a part of the practice. This spiritual aspect could potentially give ashtanga yoga an advantage as a complementary treatment for depression and anxiety.

Of course, ashtanga yoga shares all the general health and wellness benefits of other forms of hatha yoga. For example, practicing as part of a class builds social connection and community, which is often lacking in people who suffer from anxiety or depression. Yoga practice is correlated with increased oxytocin, the “love hormone” that also modulates fear, as well as heart rate variability, which appears to be related to stress modulation. Strength, flexibility and balance improve as well as an overall sense of wellbeing, supporting the mind-body connection.

Anyone suffering from depression or anxiety should first seek the consultation of licensed mental health professional such as a psychologist or psychiatrist – yoga is not meant to take the place of this type of care. I encourage you to ask your provider about the potential benefits of adding yoga to your self-care toolkit. It will be interesting to see if, in the future, some scientific research emerges to support or disprove the theory that ashtanga yoga may be particularly helpful. If any local Kansas City researchers would like to collaborate on such a project, send me a note. Until then, I’ll see you in the practice room!